# ATLANTA VASCULAR AND VEIN CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538546114
- **Authorized official:** DR. AMISH TILARA MD (PRESIDENT)
- **Authorized official phone:** (973) 632-8372

## Contact information

- **Practice address:** 600 PROFESSIONAL DR, SUITE 160A, LAWRENCEVILLE, GA 30046-7651
- **Practice address phone:** (973) 632-8372
- **Mailing address:** 1873 ROYAL TROON CT, DULUTH, GA 30097-5234
- **Mailing address phone:** (973) 632-2385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/02/2015
- **Last updated:** 08/24/2015